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In this week’s HealthCap Weekly Wrap, we break down key updates affecting senior living communities—from CMS delays and Medicaid cuts to compliance changes and enforcement trends. Here’s a closer look at the headlines we discussed in the episode:
CMS delays nursing home staffing incentives until mid-2026 — CMS is postponing the launch of its proposed nursing home staffing incentive program, giving providers more time to prepare for future workforce mandates.
Resident Assessment Instrument Manual (RAI) Update — CMS released updates to the RAI Manual supporting MDS 3.0, impacting how assessments are documented and driving quality and compliance outcomes.
CMS updates timing for Care Compare schizophrenia changes — CMS is delaying changes to the public reporting of schizophrenia-related antipsychotic use, giving providers more time to ensure accurate coding and documentation.
When the Special Focus Lens Narrows: What the Latest Data Tells Us About CMS’s SFF Program — A guest column examines how CMS is tightening its oversight of underperforming nursing homes, even those not formally on the Special Focus Facility list.
U.S. Attorney creates new section to prosecute criminal healthcare fraud — A newly launched Healthcare Fraud Section will intensify DOJ enforcement, with long-term care providers named as a key focus area.
As OIG calls out fraud, wound care stakeholders warn of decreased access to critical products — Wound care suppliers warn that aggressive fraud crackdowns may be disrupting access to medically necessary treatment products for residents.
Nursing homes face 10 percent rate cut as states begin to grapple with federal Medicaid rollbacks — North Carolina providers face deep funding cuts as state and federal Medicaid reductions take hold, potentially threatening care access and sustainability.
MLN Connects Newsletter – September 4, 2025 — CMS highlights new prior authorization demos, proof-of-delivery requirements, NCCI coding updates, and details on the TEAM model’s 3-day SNF rule waiver.
